The medical aid group Doctors Without Borders says the “dire lack of healthcare workers in southern Africa” threatens efforts to expand treatment for HIV/AIDS.

The group has issued a new report on healthcare workers in South Africa, Malawi, Mozambique and Lesotho. It calls the shortages “severe” and “compromising the quality and availability of HIV/AIDS care.”

Dr. Eric Goemaere is the head of programs in South Africa for Doctors Without Borders, also known as MSF. He works in a township about 30 kilometers from Cape Town. He says the number of new people being enrolled in MSF AIDS treatment programs has fallen because there aren’t enough nurses, nurse assistants and community health workers to handle the patient load.

“What’s happening is that the staff is exhausted and there’s no new staff coming in and no new options to delegate tasks,” he says.

He says there are several reasons for the shortages.

, there is probably not enough of them trained. And we speak here about nurses. And some will leave straight away (from) the country and some will work for the short term and then leave for greener pastures,” he says.

Dr. Goemaere says a clear message needs to be sent to healthcare workers in Africa that they are needed and appreciated.

“The message would be the following in a nutshell: This is a major challenge. It’s probably the biggest one we’ve been confronted with. We need you and we’re going to prove to you that you’re important to us. So this, in practical terms, means we’re going to pay you more. We’re going to give you a career path. And we’re going to allow you to do tasks that you were not allowed before to do, namely prescribing ARVs (anti-retroviral drugs) and treating those patients,” he says.

Lesotho, Malawi, Mozambique and South Africa are moving to train more nurses and nurse assistants. But the lure of a better life overseas can be strong.

“To give you an example, in a district we’re involved in in Lesotho, we lost last year, in only one year, 26 nurses. Where did they go? Most of them came first to South Africa and then they moved into the UK,” he says.

He says that the United States, with its own nurse shortage, is also recruiting Africans.

“We need to block and stop this poaching practice. Make sure that there’s a total ban on poaching the nurses trained in those countries that need them so much. But this will not be enough. We need to use also pull factors. And the pull factors will be to give them a real perspective in their own country,” he says.

Dr. Goemaere says if countries and donors are willing to pay for AIDS drugs for many years to come, they should also be willing to pay healthcare workers a livable wage.